BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

BACKGROUND: Post-stroke disability diminishes the physical activity (PA) level of survivors, potentially affecting their long-term prognosis. This study endeavors to explore the correlation between daily PA level and the all-cause mortality in patients with a history of stoke in the United States. METHODS: Data of stroke survivors were sourced from the National Health and Nutritional Examination Survey (NHANES) 2007-2018. The population was stratified into three groups based on their PA level. Kaplan-Meier method with log-rank tests for significance was used for survival analysis. Weighted Cox proportional hazards regression models were employed to estimate the hazard ratios (HRs) for all-cause mortality. Subgroup analysis was conducted to strengthen the results. RESULTS: A total of 1395 participants were recruited, comprising 679 males and 716 females, with a median age of 68 years. Based on their PA levels, 779 individuals were classified as inactive, 156 as insufficiently active, and 460 as sufficiently active. Following a median observation period of 59 months, there were 476 recorded deaths, with 349, 47, and 80 cases in the three respective groups. Compared to the inactive group, the HRs and 95% confidence intervals (CIs) for all-cause mortality in participants who were insufficiently active and sufficiently active were 0.58 (0.40, 0.84) and 0.47 (0.33, 0.67), respectively. The Kaplan-Meier curve revealed a significant difference in overall survival between the three groups, as confirmed by the log-rank test (P < 0.0001). Subgroup analysis further validated our results and demonstrated that the protective impact of PA on stroke prognosis varies according to distinct characteristics. CONCLUSIONS The results indicate that increased levels of PA are associated with a protective effect on long-term mortality among stroke survivors. Further prospective longitudinal studies are necessary to elucidate the optional PA level and special exercise guideline targeting this population.
Humans ; Male ; Female ; Aged ; Exercise ; Middle Aged ; Nutrition Surveys ; Stroke/mortality* ; United States/epidemiology* ; Survivors/statistics & numerical data* ; Aged, 80 and over ; Mortality

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Metabolic dysfunction-associated steatohepatitis (MASH), a severe type of metabolic dysfunction-associated steatotic liver disease (MASLD), is a leading etiology of end-stage liver disease worldwide, posing significant health and economic burdens. microRNA-320 (miR-320), a ubiquitously expressed and evolutionarily conserved miRNA, has been reported to regulate lipid metabolism; however, whether and how miR-320 affects MASH development remains unclear. By performing miR-320 in situ hybridization with RNAscope, we observed a notable downregulation of miR-320 in hepatocytes during MASH, correlating with disease severity. Most importantly, miR-320 downregulation in hepatocytes exacerbated MASH progression as demonstrated that hepatocyte-specific miR-320 deficient mice were more susceptible to high-fat, high-fructose, high-cholesterol diet (HFHC) or choline-deficient, amino acid-defined, high-fat diet (CDAHFD)-induced MASH compared with control littermates. Conversely, restoration of miR-320 in hepatocytes ameliorated MASH-related steatosis and fibrosis by injection of adeno-associated virus 8 (AAV8) carrying miR-320 in different types of diet-induced MASH models. Mechanistic studies revealed that miR-320 specifically regulated fibroblast growth factor 1 (FGF1) production in hepatocytes by inhibiting regulator factor X1 (RFX1) expression. Notably, knockdown of Rfx1 in hepatocytes mitigated MASH by enhancing FGF1-mediated AMPK activation. Our findings underscore the therapeutic potential of hepatic miR-320 supplementation in MASH treatment by inhibiting RFX1-mediated FGF1 suppression.

Objective To investigate the risk factors for stroke-associated pneumonia(SAP)in patients with acute anterior circulation large-vessel occlusion stroke after endovascular treatment(EVT).Methods A total of 115 patients with acute anterior circulation large-vessel occlusion stroke who received EVT in the Department of Neurology,The First Affiliated Hospital of Xi'an Jiaotong University,from March 2022 to May 2023 were continuously included.Their clinical data were retrospectively collected.The patients were divided into SAP group(55 cases)and non-SAP group(60 cases)according to the occurrence of SAP after the operation.Differences in baseline data,surgical and perioperative indicators were compared between the two groups,and the risk factors for SAP after EVT were analyzed using the multivariate Logistic regression analysis.Results Univariate analysis showed there were significant differences in the Glasgow Coma Scale(GCS)score and the National Institute of Health Stroke Scale(NIHSS)score at admission,incidence of dysphagia,duration of the surgery,proportion of general anesthesia,rate of unsuccessful vascular recanalization and the rate of immediate CT high-density sign between SAP group and non-SAP group(all P＜0.05).Multivariate Logistic regression analysis of the above indicators showed that duration of the surgery(OR=1.014,95％CI:1.001-1.028,P＜0.05),dysphagia(OR=6.137,95％CI:1.694-22.232,P＜0.01)and unsuccessful vascular recanalization(OR=6.043,95％CI:1.062-34.382,P＜0.05)were independent risk factors for SAP after EVT.Conclusion Long duration of EVT,dysphagia and unsuccessful vascular recanalization are directly related to the occurrence of SAP after EVT in patients with acute anterior circulation large-vessel occlusive infarction.Therefore,targeted measures should be taken as soon as possible to reduce the incidence of SAP after EVT and thus improve the clinical prognosis of these patients.

With the rapid increase in the ownership of MRI equipment in China,quality control,particularly in clinical usage aspects,has become critically important.For clinical quality control of MRI systems,it is essential to establish comprehensive workflow principles encompassing multiple elements such as personnel,equipment,standards,tools and methodologies.To advance the standardization and widespread adoption of clinical quality control for MRI equipment,efforts must focus on strengthening regulatory frameworks,advancing phantom research,development and enhancing professional expertise.Concurrently,continuous improvements in training programs and supervision mechanisms are necessary to ensure the effective implementation of MRI clinical quality control practices.Furthermore,in the era of digital healthcare,clinical quality assurance for MRI equipment is evolving toward automation and intelligent solutions,providing higher-quality and more efficient assurance for clinical applications.

Purpose To measure the spatial resolution in MRI quality control testing automatically based on the American College of Radiology(ACR)phantom using the support vector machine(SVM)method,and the feasibility,accuracy and measurement speed of this method are explored.Materials and Methods Quality control tests were performed using eight MRI devices at Beijing Friendship Hospital of Capital Medical University.A retrospective study was conducted on 71 MRI quality control test images collected based on ACR phantoms between 2017 and 2019.The images were preprocessed by binarization,extraction region of interest and so on.An SVM-based classification model was constructed for analyzing the spatial resolution of dot arrays in row and column directions.The dataset was randomly split into a training set and a test set.The generalization performance of the classification model in this study was evaluated through accuracy,precision,recall and F1 score on the test set.Comparing the results of spatial resolution measurements obtained by both manual and automatic method,we demonstrated the feasibility and accuracy of the method.Additionally,the time taken for the automatic spatial resolution measurement was recorded.Results In this study,the proposed method of automatically measuring the spatial resolution of ACR phantom test images using SVM was feasible,high accuracy and short time.In classification performance test,the accuracy of the spatial resolution of the row directional latices was 95%,the precision was 100%.The accuracy of the spatial resolution of the column directional latices was 97%,the precision was 100%.Among the test cases,the results of automatic measurements matched those of manual measurements in 13 out of 14 cases.On average,automatic spatial resolution measurement took 0.158 seconds per case.Conclusion This study achieves automatic measurement of spatial resolution in MRI quality control based on the ACR phantom using SVM method.The method demonstrates high accuracy and fast measurement speeds,holding significant implications for future rapid MRI quality control stability testing.

Purpose To explore an automatic detection method for quality control performance indicators of radio frequency coils based on American College of Radiology(ACR)phantom,and verify its accuracy stability and computational efficiency.Materials and Methods A retrospective study was conducted on 50 quality control images collected based on ACR phantom in Beijing Friendship Hospital,Capital Medical University from May 2017 to July 2019.The measurement and calculation methods of signal noise ratio(SNR),percent image uniformity(PIU)and percent signal ghosting(PSG)were used to automatically calculate the above indicators using a self-designed program in Python.A simple linear regression analysis on the automatically calculated SNR,PSG and PIU values compared to the manually measured results was performed,and Bland-Altman analysis was used to calculate the percentage difference to evaluate the consistency and bias between the performance indicators calculated by the two methods.The time consumption of two detection methods was compared to verify their computational complexity and efficiency.Results There was a strong correlation between the performance indicators SNR,PSG and PIU of radio frequency coils measured and calculated automatically and manually(r=0.991 4,0.992 8 and 0.909 8,all P<0.0001).The Bland-Altman results showed that most of the data fall within the 95%confidence interval and were evenly distributed.In terms of computational complexity and efficiency,compared to the complex manual delineation and calculation of 2-3 minutes per case,automatic detection could simultaneously obtain SNR,PSG and PIU values in less than 1 second.Conclusion The automatic and manual measurement methods have good consistency,and the automatic detection method is easy to operate,which is helpful for the daily quality control work and performance monitoring of radio frequency coils.

Objective:To understand the status of bone health literacy in middle-aged and older female breast cancer patients undergoing chemotherapy and analyze its influencing factors using structural equation modeling.Methods:A convenience sampling method was used to select 250 middle-aged and older breast cancer patients undergoing chemotherapy in two tertiary hospitals in Xi'an from May to October 2024. Patients were surveyed using a general information questionnaire, the Bone Health Literacy Scale for Middle-Aged and Older Women, the Perceived Social Support Scale, and the General Self-Efficacy Scale. Pearson correlation analysis was used to examine the correlations among bone health literacy, perceived social support, and self-efficacy.Results:A total of 250 questionnaires were distributed, and 239 valid questionnaires were recovered, yielding an effective response rate of 95.6% (239/250). The mean score of the Bone Health Literacy Scale among the 239 patients was (39.71±8.16). Bone health literacy was positively correlated with perceived social support and self-efficacy ( P<0.01). Perceived social support directly affected bone health literacy and could also indirectly influence it through general self-efficacy, with an indirect effect value of 0.367, accounting for 45.2% of the total effect (0.367/0.812) . Conclusions:Healthcare professionals should implement effective interventions to enhance patients' perceived social support and strengthen their self-efficacy, thereby improving bone health literacy.